Catheter-associated urinary tract infection (UTI) is one of the most common hospital-acquired infections (HAI) and has affected 450,000 patients and added approximately $450 million to annual healthcare costs in the US in 2002 (as adjusted to 2007 value). An estimated 13,000 of the patients die from their UTI each year. Foley catheters are the standard of care for patients requiring indwelling catheterization; however, just having an indwelling Foley catheter for over six days may increase the likelihood of developing a UTI from approximately 5 times to approximately 7 times. Two thirds of UTIs from urinary catheters potentially develop when bacteria, usually from the digestive tract, stick to the external surface of the Foley catheter, where there is no flow of urine, presenting a warm, moist, stagnant space that is ideal for biofilm growth. In addition to a risk of infection, Foley catheters can be painful due to their large diameter and may put patient safety at risk due to the large balloon that holds the device in the bladder. Patients who are demented or coming off of anesthesia may attempt to pull their catheter out, which can damage the urethra and potentially require additional surgery to repair, leading to additional costs and the potential for future health problems.
In 2008, the Centers for Medicare and Medicaid Services (CMS) announced that hospital-acquired UTI would no longer be covered, meaning hospitals are responsible for the cost and must focus on prevention rather than treatment of UTI. Additionally, in 2014, the 25% of hospitals with the highest rate of HAI will be subject to a 1% Medicare reimbursement penalty, estimated to be approximately $208 k per hospital. UTI rates are currently published on medicare.gov for around 70% of hospitals and 96% of nursing homes, and will be mandatory effective in 2014. Thus, there has developed a need to decrease infection rates in patients with indwelling urinary catheters.